Research Article| Volume 8, ISSUE 1, P23-30, March 1992

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A technique for arthroscopic subacromial decompression

  • Richard B. Caspari
    Address correspondence and reprint requests to Dr. Richard B. Caspari, Tuckahoe Orthopaedic Associates, Ltd., Orthopaedic Research of Virginia, 8919 Three Chopt Road, Richmond, VA 23229, U.S.A.
    Tuckahoe Orthopaedic Associates, Ltd., Richmond, Virginia USA

    the Orthopaedic Research of Virginia, Richmond, Virginia USA
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  • Author Footnotes
    1 Dr. Thal's present address is Town Center Sports Injury Clinic, 1800 Town Center Dr., #111, Reston, VA 22090, U.S.A.
    Raymond Thal
    1 Dr. Thal's present address is Town Center Sports Injury Clinic, 1800 Town Center Dr., #111, Reston, VA 22090, U.S.A.
    Town Center Sports Injury Clinic, Reston, Virginia USA
    Search for articles by this author
  • Author Footnotes
    1 Dr. Thal's present address is Town Center Sports Injury Clinic, 1800 Town Center Dr., #111, Reston, VA 22090, U.S.A.
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      The control of bleeding and the determination of the appropriate amount of bone to resect are two common technical difficulties in performing arthroscopic subacromial decompression. We describe a technique that simplifies the procedure while providing more precise bone resection and contouring. First, the coracoacromial ligament is released by sectioning the anterior margin of the acromion. Bleeding is minimized with this technique because the coracoacromial ligament itself is not being cut, but rather its bony attachment is resected. An acromioplasty is then performed with the arthroscope in the lateral portal and the burr in the posterior portal. The shank of the cutter is rested against the posterior lip of the acromion, which acts as a fulcrum. The tip of the burr is placed at the deepest point of the concavity of the acromion. Bone is resected by sweeping the cutter from lateral to medial and progressing anteriorly while maintaining the angle of the burr, using the angle of the posterior acromion as a guide. In this way the appropriate amount of bone is automatically resected, resulting in a flat acromion which is tapered anteriorly and has a smooth transition to normal bone posteriorly.


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